Vital Statistics Form

Please fill this form out as much as possible. It will help us to complete the death certificate and in writing the obituary. All fields with an asterisk are required.

Deceased's Information

If residence, please include address
mm/dd/yyyy
English, Irish, French, German, etc.
Be specific
Primary occupation during working years. *Do not enter \"retired\".
Sales, Medical, Engineering, Construction, etc.
Please list survivors and relationship: son, daughter, brother, sister, etc.
Religious affiliations, fraternal and civic organizations, hobbies, etc.

Informant's Information

A copy of what is submitted will be sent to this email.
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Obituaries & Condolences

David Allen Johnson

Enora “Itsy” Lauma Luss Finch

Barbara Jeane (Nelson) Blair

Kent Richardson

Carolyn Denise Dykes (Boyer)

Agatha Josephine Steen

Jerry Wayne Finley

Stan Martin Butler

James ‘Jim’ Leroy Hoestje

Geraldine Marie Spillers

Kathy Diana Dillard

Carla Denise Reynolds Hotvedt